Challenges to Neurosurgery During the Coronavirus Disease 2019 (COVID-19) Pandemic

Research output: Contribution to journalReview articlepeer-review


  • Georgios Tsermoulas
  • Athanasios Zisakis
  • Graham Flint
  • Antonio Belli

External organisations

  • Queen Elizabeth Hospital Birmingham, Queen Elizabeth Medical Centre


The coronavirus disease 2019 pandemic has presented a massive burden to most health care systems across the globe. The demand for intensive care unit capacity in particular has increased significantly, and hospitals in most affected regions have struggled to cope. The focus of health care activity has shifted to the pandemic, with a negative impact on the management of other conditions. Neurosurgery, like most specialties, has been drastically affected but, arguably, warrants special considerations because many of the treatments required are time-critical. Lack or delay of appropriate intervention may lead, for an individual patient, to permanent neurologic injury and a significant decline in function and quality of life, or even death. In this report, we consider the challenges that neurosurgeons currently face in relation to the pandemic and are likely to face in the foreseeable future. The challenges are multifaceted with practical, ethical, legal, and other implications. These include re-deployment of staff to areas outside neurosurgery, treatment priority setting, ethical decision-making and risk of moral injury, as well as medicolegal risks, financial uncertainties and implications for training, research, and global health work. As well as patients, these challenges will affect neurosurgeons as doctors and as humans. The international neurosurgical community has a moral duty to contribute to the global response to the COVID-19 crisis, but also to retain a duty to care for individual patients.

Bibliographic note

Copyright © 2020 Elsevier Inc. All rights reserved.


Original languageEnglish
Pages (from-to)519-525
Number of pages7
JournalWorld Neurosurgery
Publication statusPublished - Jul 2020
Externally publishedYes


  • Betacoronavirus, Coronavirus Infections/epidemiology, Delivery of Health Care/methods, Humans, Neurosurgeons/trends, Neurosurgery/methods, Pandemics, Pneumonia, Viral/epidemiology